The metabolism of cortisol (llβ,17α,21-trihydroxy-4-pregnene-3,20-dione) in an ovariectomized, adrenalectomized patient with breast cancer was investigated. Following administration of [4-14C]-cortisol to the subject, urine samples were collected. The steroid conjugates were extracted from the urine and hydrolyzed, and the free steroids removed by solvent extraction. The estrogen fraction of the urine was separated by sodium hydroxide extraction and purified by counter-current distribution. The extracted estrogen fraction was analyzed by thin-layer chromatography and gas chromatography-mass spectrometry. Gas chromatography-mass spectrometry (GC-MS) of the trimethylsilyl-ethers of the steroids served to identify several radioactive metabolites of [4-14C]-cortisol. One of the urinary metabolites identified was 11β hydroxyestradiol [1,3,5(10)-estratrien-3,11β,17ξ-triol]. The clinical implication of the conversion of an adrenocortical steroid to an estrogenic steroid is discussed.
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